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Colostomy
A colostomy is a surgical procedure that involves connecting a part of the colon onto the anterior abdominal wall, leaving the patient with an opening on the abdomen called a stoma. In a colostomy, the stoma is formed from the end of the large intestine, which is drawn out through the incision and sutured to the skin. After a colostomy, faeces leave the patient's body through the stoma. A colostomy may be permanent or temporary, depending on the reasons for its use. Indications There are many reasons for this procedure. Some common reasons are: *A section of the colon has had to be removed, e.g. due to colon cancer requiring a total mesorectal excision, diverticulitis, injury, etc, so that it is no longer possible for feces to pass out via the anus. *A portion of the colon (or ileum) has been operated upon and needs to be 'rested' until it is healed. In this case, the colostomy is often temporary and is usually reversed at a later date, leaving the patient with a small scar in place of the stoma. Children undergoing surgery for extensive pelvic tumors commonly are given a colostomy in preparation for surgery to remove the tumor, followed by reversal of the colostomy. Options Placement of the stoma on the abdomen can occur at any location along the colon, the majority being on the lower left side near or in the sigmoid colon, other locations include; the ascending, transverse, and descending sections of the colon. Colostomy surgery that can be planned ahead often has a higher rate of long-term success and satisfaction, than those done in emergency surgery. Colostomy with irrigation Colostomates (people with colostomies) who have ostomies of the sigmoid colon or descending colon may have the option of irrigation, which allows for the person to not wear a pouch, but rather just a gauze cap over the stoma, and to schedule irrigation for times that are convenient. To irrigate, a catheter is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve. Most colostomates irrigate once a day or every other day, though this depends on the person, their food intake, and their health. Colostomy without irrigation Colostomies are viewed negatively due to the misconception that it is difficult to hide the pouch and the smell of feces, or to keep the pouch securely attached. However, modern colostomy pouches are well-designed, odor-proof, and allow stoma patients to continue normal activities. Latex-free tape is available for ensuring a secure attachment. People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed several times a day depending on the frequency of activity; in general the further from the anus the ostomy is located the greater the output and more frequent the need to empty or change the pouch. Alternatives In some rare situations it may be possible to opt for an internal colo-anal pouch which eliminates the need for an external pouch. In place of an external appliance, an internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to act as a new rectum to replace the removed original. Psychological adjustment See also * Ileostomy References *Adam, G., Balazs, L., Vidos, T., & Keszler, P. (1990). Detection of colon distension in colonostomy patients: Psychophysiology Vol 27(4) Jul 1990, 451-456. *Amsterlaw, J., Zikmund-Fisher, B. J., Fagerlin, A., & Ubel, P. A. (2006). 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F. (2005). The sickening process of colostomy patients by cancer: Revista Latino-Americana de Enfermagem Vol 13(2) Mar-Apr 2005, 216-222. *McVey, J., Madill, A., & Fielding, D. (2001). The relevance of lowered personal control for patients who have stoma surgery to treat cancer: British Journal of Clinical Psychology Vol 40(4) Nov 2001, 337-360. *Nesci, D. A., Menichincheri, R., Poliseno, T., & Ferro, F. M. (1988). The limit in stoma patients: Archivio di Psicologia, Neurologia e Psichiatria Vol 49(2) Apr-Jun 1988, 176-185. *Oades-Souther, D., & Olbrisch, M. E. (1984). Psychological adjustment to ostomy surgery: Rehabilitation Psychology Vol 29(4) Win 1984, 221-237. *Orbach, C. E. (1974). Ideas of contamination in postoperative colostomy patients: Psychoanalytic Review Vol 61(2) Sum 1974, 269-282. *Orbach, C. E. (1975). Time and inhibition in the adaptation of patients with colostomies: Psychoanalytic Review Vol 62(4) Win 1975-1976, 663-673. *Orbach, C. E., & Tallent, N. (1965). 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Social support and adaptation to an ostomy: An examination of members and nonmembers of a medical mutual aid group: Dissertation Abstracts International. *Taylor, G. R., & MacKenney, L. (2001). Trends in special education. Springfield, IL: Charles C Thomas Publisher. *Tedeschi, M., & Saviano, M. S. (1984). Considerations on a case of "phantom rectum." Medicina Psicosomatica Vol 29(2) 1984, 183-193. *Thomas, C., Madden, F., & Jehu, D. (1984). Psychosocial morbidity in the first three months following stoma surgery: Journal of Psychosomatic Research Vol 28(3) 1984, 251-257. *Thomas, C., Madden, F., & Jehu, D. (1987). Psychological effects of stomas: I. Psychosocial morbidity one year after surgery: Journal of Psychosomatic Research Vol 31(3) 1987, 311-316. *Thomas, C., Madden, F., & Jehu, D. (1987). Psychological effects of stomas: II. Factors influencing outcome: Journal of Psychosomatic Research Vol 31(3) 1987, 317-323. *Thomas, C., Turner, P., & Madden, F. (1988). Coping and the outcome of stoma surgery: Journal of Psychosomatic Research Vol 32(4-5) 1988, 457-467. *Thunberg, U. H., & Kemph, J. P. (1977). Common emotional reactions to surgical illness: Psychiatric Annals Vol 7(1) Jan 1977, 20-28. *Weerakoon, P. (2001). Sexuality and the patient with a stoma: Sexuality and Disability Vol 19(2) Sum 2001, 121-129. *Wirsching, M., Druner, H. U., & Herrmann, G. (1975). Results of psychosocial adjustment to long-term colostomy: Psychotherapy and Psychosomatics Vol 26(5) 1975, 245-256. External links * United Ostomy Associations of America * An honest and humorous description of life after a colostomy * Ostomyland – Interactive Ostomy community, covering Colostomy, Ileostomy and Urostomy * Living with a Colostomy – Informational sister site to ostomyland.com. Detailed Colostomy lifestyle guide covering before, during and after the op * My colostomy story and some colostomy pictures Category:Surgery Category:Gastroenterology Category:Physiclal health psychology Category:Surgical procedures